Prostate screening critical for men as they age
Courtesy of Metro Creative
Men over the age of 50 should speak with their doctor about routine screenings for prostate cancer.
Dr. Mohsen Issac
Nearly one in eight men in the United States will be diagnosed with prostate cancer during his lifetime?
The disease is a leading cause of cancer deaths in men.
“That is a fact, even though prostate cancer is the second leading cause of cancer death in American men behind only lung cancer,” said Dr. Mohsen Isaac, medical director of radiation oncology at Monongahela Valley Hospital.
Issac said about one in 41 men will die of prostate cancer.
The U.S. Preventative Task Force recommends men under 40 do not need routine screening for prostate cancer unless they have a family history of the disease.
At age 45, those in high-risk categories should be screened – this includes African American men and those with a father or brother diagnosed at an early age.
At age 50, men who are at average risk of prostate cancer, and are expected to live at least 10 more years, should have a routine screening.
PSA screening
Prostate cancer is usually screened by doing a blood test for an oncologic biomarker called prostate specific antigen, or PSA, which is produced by the glandular epithelium of the prostate.
“Other factors can affect the PSA such as infection, inflammation, urinary retention, advanced age and benign prostate enlargement,” Isaac said. “So even though PSA is not a perfect test, there is a way to improve the PSA for diagnosing prostate cancer such as PSA density, PSA velocity, percent of free PSA and age specific thresholds rather than the cutoff value of 4.”
The U.S. Preventative Task Force revised its PSA screening in 2013 based on a study comparing it to a digital rectal exam. The study found no significant difference of death by adding the PSA to normal standard care.
“In the past maybe we overtreated prostate cancer patients,” Isaac said. “But we can utilize PSA better and age specific thresholds and maybe add new biomarkers to aid in selection for biopsy so we can avoid unnecessary prostate biopsies.”
Isaac said using prostate MRI fusion for more accurate biopsies, along with genomic testing to help better define risks, might be better courses of action for physicians.
“Even though you can diagnosis prostate cancer, it does not mean patients have to be treated but they could be better evaluated for watchful waiting,” he said.
Free screening event
Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 3.1 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. To help promote screening, MVH is offering a free prostate screening program at 5 p.m. Oct. 6 in the Anthony M. Lombardi Education Conference Center. Attendees will learn about the importance of early detection and have the option to receive an exam by MVH’s medical staff along with a prostate specific antigen (PSA) blood test.
“There are no clear symptoms for early-stage prostate cancer and this is what makes it a silent killer,” Isaac said. “When it advances, it can cause symptoms such as urine frequency, urine urgency and blood in the hematuria (blood in the urine). Sometimes prostate cancer can spread to the bones causing bone pain.”
Treatment options
The earlier the prostate cancer stage, the more treatment options are available for treating the condition.
“First, they have to be diagnosed by prostate biopsy,” Isaac said. “Options of treatment vary from watchful waiting (based on age, risk factor and pathology report), surgery or radiation therapy. Sometimes hormone therapy could be added to the radiation treatment to improve patient outcome.”
Isaac said prostate cancer is a very survivable form of cancer if it is diagnosed early.
“But still, prostate cancer is the second leading cause of cancer death for men in the United States because the biology of prostate cancer is not the same for all men,” he said.
The MVH free screening program is intended for men ages 50-75 who do not already have a diagnosis of prostate problems. Appointments are limited and advance registration is required. Free parking will be provided. For more information or to register, call 724-258-1333 or visit monvalleyhospital.com.